Endocrinology Unit

Policlinico San Donato

key figures 

CLINICAL SERVICES:

  • Diabetology
  • Endocrinology
  • Nutrition

PROCEDURES PERFORMED PER YEAR:

  • 5000 outpatient clinical services
  • 100 inpatient services

The Endocrinology and Metabolic Diseases Department at Policlinico San Donato consists of two Outpatient services Units: The Diabetes and Metabolism Unit, and the Endocrinology Unit, in addition to the two Inpatient wards: The Endocrinology ward, and the Nutritional Rehabilitation ward. The Department is led by Professor Livio Luzi, and three dedicated Supervisors coordinate clinical activities within each Medical Area (Diabetes, Endocrinology, and Nutrition). A total of four Endocrinologists, one Diabetologist, one Internal Medicine Specialist, one Dietician, and two Nutritional Biologists work in the team.  Eleven nurses (1 Research Nurse and 10 Clinical nurses) collaborate in the inpatient and outpatient clinics.

The Endocrinology and Metabolic Diseases Department offers clinical services to patients affected by diabetes (type 1 and type 2), obesity, thyroid diseases (hypothyroidism, hyperthyroidism, thyroid nodules, thyroid cancer), parathyroid disorders, adrenal glands disorders, osteoporosis, pituitary gland disorders and hypogonadism.

A Research group led by Professor Livio Luzi, is also part of the Department, running cutting-edge research projects on innovative obesity treatment such as Deep Transcranial Magnetic Stimulation, diabetes, cardiovascular complications and thyroid disorders.

 

treatmentS

Diabetes

Four Diabetes outpatient clinics are weekly run by three MDs dedicated to diabetes care. Patients are diagnosed and treated following up-to-date national and international guidelines. During consultations nutritional advice and education sessions on diabetes management are provided. A special focus on diabetic neuropathy and diabetic foot ulcers is ensured by the two fully trained physicians specialised in diabetic neuropathy screening, and foot ulcers prevention and treatment.

Another special focus is the management of insulin pump therapy in type 1 diabetes patients. About 100 patients with type 1 diabetes are treated and followed-up by a team of 3 specialists, with significant experience in the use of insulin pumps.

During the visits, patients are instructed on the use of patch insulin pumps, sensor controlled low glucose pumps, continuous glucose monitoring, and prevention of hypoglycaemia.

Main Pathologies Treated:

  • Type 1 & Type 2 Diabetes
  • Secondary forms of diabetes
  • Diabetic neuropathy
  • Diabetic foot ulcers

Top Procedures:

  • Diabetes consultation
  • Nutritional consultation
  • Diabetic foot ulcers screening and treatment
  • Diabetic neuropathy screening
  • Insulin pump management

Endocrinology

Eight Endocrine outpatient clinics are weekly run by three dedicated MDs. Patients are diagnosed and treated following up-to-date national and international guidelines, offering the best possible care. Indirect calorimetry is performed to measure resting energy expenditure in our patients.

The Endocrine division has a long tradition in the management of adrenal gland disorders and osteoporosis and is well-known for its expertise and know-how. It also offers treatments for Thyroid diseases, including benign disorders and malignancies.  

A Day Hospital service is available in order to perform diagnosis and treat patients affected by more complex clinical disorders.  

Main Pathologies Treated:

  • Thyroid diseases (hypothyroidism, hyperthyroidism, thyroid nodule, thyroid cancer)
  • Adrenal glands disorders
  • Osteoporosis
  • Pituitary gland disorders

Top Procedures

  • Endocrine consultation
  • Day Hospital service (dynamic tests)

Nutrition

Two dedicated MDs run weekly three Nutrition outpatient clinics.

Patients with obesity are offered a comprehensive clinical approach with tailored nutritional consultations ensured by a close collaboration between MDs and Specialised Dieticians. Indirect calorimetry is performed to measure resting energy expenditure in our patients, in addition to air displacement plethysmography to assess body composition.

A cutting-edge technology, Deep Transcranial Stimulation, is available and it represents a new, safe, and non-invasive technique for tackling the core of obesity pathophysiology.

Main Pathologies Treated:

  • Obesity
  • Nutritional deficiencies
  • Enteral/Parenteral nutritional support

Top Procedures:

  • Nutritional consultation
  • Personalised nutritional plans
  • Indirect calorimetry
  • Air displacement plethysmography
  • Deep Transcranial Magnetic Stimulation

Experimental Treatments

Research projects on the use of Deep Transcranial Magnetic Stimulation in patients with obesity started in 2015 and are currently on going in the Division.

Deep Transcranial Magnetic stimulation (dTMS) is an innovative and non-invasive technology which modulates the dopaminergic system, also known as the reward system, implicated in eating behaviour and food cravings, altered in patients with obesity. This technique requires the use of an external helmet-shaped device, which allows the application of magnetic fields.

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • BOD POD Body Composition System (Cosmed, Italy): air displacement plethysmography, analyses body composition in terms of fat and lean mass.   
  • Indirect calorimeter (QuarkRMR Cosmed, Italy): it is used to measure the resting energy expenditure through the calculation of the respiratory quotient.
  • Infrared camera (Avio model R500Ex-Pro thermal imaging camera): infrared thermography is used to analyse abdominal skin, fingernail-bed hand and interscapular skin temperature in patients with obesity enrolled in our experimental protocol (Deep Transcranial Magnetic Stimulation).
  • Deep Transcranial Magnetic Stimulator:  innovative and non-invasive neuromodulation technology (dopaminergic system) to treat obesity through the use of an external helmet.